Motor Rehabilitation Therapies Research Articles

Operational encoding enhances action knowledge integration: insights from event-related potential analysis.

In this study, we conducted an examination of knowledge integration concerning action information and assessed the impact of operational on this process. Additionally, we delved into the underlying mechanisms of how operational encoding influences the processing of knowledge integration of action information, utilizing the event-related potential technique. The results of our investigation revealed that operational encoding, encompassing the observed operational encoding and the imagined operational encoding, exhibited superior performance in the integration of action knowledge compared to verbal encoding. This distinction may be attributed to the greater efficiency of operant encoding in activating motor cortical areas, thereby inducing more robust brain activity. These findings suggest the potential advantages of operational encoding in facilitating the integration of knowledge related to movement information at both cognitive and neural levels, underscoring its significant role in the processing of such information. Future studies can further explore the applications of operational encoding in domains, such as motor learning, skill training, and rehabilitation therapy. Such investigations may offer novel insights into enhancing human behavior and motor control.

Quantitation of Body Movement in a Motor Physical Therapy for Parkinson’s Disease

The present work shows the quantitation of body movement in a motor physical therapy for Parkinson’s Disease (PD). In recent years, many activities of therapy were carried out remotely using common RGB cameras to capture the body movements. We analyze the body movements of 8 subjects with clinical diagnosis of PD, and compare them with a control group of 11 healthy volunteers, processing their respective RGB video recordings with a software that identifies 17 specific body keypoints while subjects perform two motor rehabilitation therapies (cervical and lumbar spine). All videos were analyzed by OpenPose algorithm and angles from keypoints detected were computed to infer the rotation, rate and amplitude of movement of head, shoulder, back and pelvis. The results show that OpenPose algorithm could be used in a home environment specially in follow-up and management of the motor rehabilitation therapy for Parkinson’s disease.

Brain-Computer Machine-based Rehabilitation Procedure Efficiency For Post-Stroke

Stroke still remains one of the major cause of disability. The post-stroke impact one may experience is multifaceted, from motor, cognitive, and emotional influences, reducing one's quality of life. Past treatments developed in the past had strict requirements, therefore limiting treatment enrollments. Recent research on brain-machine interface-based therapy for post-stroke motor rehabilitation showed promising outcomes. Moreover, these BMIs have been modified to consist of different signal acquisition and device outputs, to be centered around post-stroke cognitive and emotional influences. BMI based system relays on the mechanisims of neuroplasticity, and the the present essay attempted to explore the efficiency of different BMI systems in maximizing neuroplasticities in order to restore motor and cognitive impairements. Moreover, the essay also explored the regulatory efficiency in combating post-stroke related depressive issues. As conclusion, BMI shows promosing results in promoting motor and cognitive rehabilitation, also showing encouraging prospect in mood regulation. However, evidence focusing on the transferability and endurance of these observed effects is still largely lacking.

Caregiver burden in parents of children with neurological impairement and its relation with depression

IntroductionCaregiving negatively affects the psychological and physical health of the caregivers, especially in parents of children with neurological impairement (NI).Furthermore, the behavior and demands of the patient make the caregivers encounter increased stress levels and negative thoughtsabout the future that may lead to depression in caregivers.ObjectivesTo assess the relationship between caregiver burden and symptoms of depression in parents of children with NI.MethodsA total of 33 caregivers of children with NI, participated in this cross-sectional, descriptive and analytical study, carried out in Child Neurology Department of the University Hospital in Sfax (Tunisia), between February and April 2021.The Zarit-Caregiver-Burden-Scale (Zarit-CBS) and the Beck Depression Scale were administered.ResultsThe average age of the caregivers (27 mothers and 6 fathers) was 38,33 years ± 6,53 years. Among the parents, 81,81% didn’t exceed the secondary educational level and75,75% of them had an irregular occupation. The average age of the children (21 boys and 12 girls) was 7,58±4,29 years.Near to the half of them (51,51%) had intellectual disability.Over 54.54% of the children had a functional independence, while 21.21% required help in walking and 24.24% were unable to walk.The intervention was based on motor rehabilitation (57,57%), adequate equipment (24,24%), ergotherapy (45,45%) and speech therapy (60,6%).After the intervention, 63,63% of children had an improvement and 30,3% had a stationary state.The mean score of Zarit-CBS was 52,45±14,26. The caregiver burden was noted in 96,96%.The mean score of Beck was 9,33±5,48. The depression was noted in 78,78%.The total Zarit-CBS score had positive correlation with Beck scores (p=0.038).ConclusionsThere is a positive relationship between the caregiver burden and depression symptoms. Thus, effort should be made to relieve caregiver burden in parents of children with NI.Disclosure of InterestNone Declared

Characterization of Functional Connectivity in Chronic Stroke Subjects after Augmented Reality Training

Augmented reality (AR) tools have been investigated with promising outcomes in rehabilitation. Recently, some studies have addressed the neuroplasticity effects induced by this type of therapy using functional connectivity obtained from resting-state functional magnetic resonance imaging (rs-fMRI). This work aims to perform an initial assessment of possible changes in brain functional connectivity associated with the use of NeuroR, an AR system for upper limb motor rehabilitation of poststroke participants. An experimental study with a case series is presented. Three chronic stroke participants with left hemiparesis were enrolled in the study. They received eight sessions with NeuroR to provide shoulder rehabilitation exercises. Measurements of range of motion (ROM) were obtained at the beginning and end of each session, and rs-fMRI data were acquired at baseline (pretest) and after the last training session (post-test). Functional connectivity analyses of the rs-fMRI data were performed using a seed placed at the noninjured motor cortex. ROM increased in two patients who presented spastic hemiparesis in the left upper limb, with a change in muscle tone, and stayed the same (at zero angles) in one of the patients, who had the highest degree of impairment, showing flaccid hemiplegia. All participants had higher mean connectivity values in the ipsilesional brain regions associated with motor function at post-test than at pretest. Our findings show the potential of the NeuroR system to promote neuroplasticity related to AR-based therapy for motor rehabilitation in stroke participants.

Research progress on mechanical perturbation in stroke rehabilitation

Sensorimotor disorder can be easily caused by stroke, and there are many targeted movement rehabilitation therapies. With the development of rehabilitation robot technology, robot-assisted therapy combined with mechanical perturbations has become a more effective motor rehabilitation therapy. In this paper, the definition of mechanical perturbation and its physiological mechanism in stroke rehabilitation are introduced, the research progress on mechanical perturbation in the field of stroke rehabilitation therapy is mainly discussed, the application of mechanical perturbation in motor control, postural response and sensory evaluation of stroke rehabilitation is summarized, and the future development direction of mechanical perturbation rehabilitation therapy is also prospected.

Effectiveness of Using Virtual Reality-Supported Exercise Therapy for Upper Extremity Motor Rehabilitation in Patients With Stroke: Systematic Review and Meta-analysis of Randomized Controlled Trials.

BackgroundIn recent years, efforts have been made to implement virtual reality (VR) to support the delivery of poststroke upper extremity motor rehabilitation exercises. Therefore, it is important to review and analyze the existing research evidence of its effectiveness.ObjectiveThrough a systematic review and meta-analysis of randomized controlled trials, this study examined the effectiveness of using VR-supported exercise therapy for upper extremity motor rehabilitation in patients with stroke.MethodsThis study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The CINAHL Plus, MEDLINE, Web of Science, Embase, and Cochrane Library databases were searched on December 31, 2021. Changes in outcomes related to impairments in upper extremity functions and structures, activity limitations, and participation restrictions in life situations from baseline to after intervention, after intervention to follow-up assessment, and baseline to follow-up assessment were examined. Standardized mean differences (SMDs) were calculated using a random-effects model. Subgroup analyses were performed to determine whether the differences in treatment outcomes depended on age, stroke recovery stage, VR program type, therapy delivery format, similarities in intervention duration between study groups, intervention duration in VR groups, and trial length.ResultsA total of 42 publications representing 43 trials (aggregated sample size=1893) were analyzed. Compared with the control groups that used either conventional therapy or no therapy, the intervention groups that used VR to support exercise therapy showed significant improvements in upper extremity motor function (Fugl-Meyer Assessment-Upper Extremity; SMD 0.45, 95% CI 0.21-0.68; P<.001), range of motion (goniometer; SMD 1.01, 95% CI 0.50-1.52; P<.001), muscle strength (Manual Muscle Testing; SMD 0.79, 95% CI 0.28-1.30; P=.002), and independence in day-to-day activities (Functional Independence Measure; SMD 0.23, 95% CI 0.06-0.40; P=.01, and modified Rankin Scale; SMD 0.57, 95% CI 0.01-1.12; P=.046). Significant subgroup differences were observed in hand dexterity (Box and Block Test), spasticity (Ashworth Scale or modified Ashworth Scale), arm and hand motor ability (Wolf Motor Function Test and Manual Function Test), hand motor ability (Jebsen Hand Function Test), and quality of life (Stroke Impact Scale). There was no evidence that the benefits of VR-supported exercise therapy were maintained after the intervention ended.ConclusionsVR-supported upper extremity exercise therapy can be effective in improving motor rehabilitation results. Our review showed that of the 12 rehabilitation outcomes examined during the course of VR-based therapy, significant improvements were detected in 2 (upper extremity motor function and range of motion), and both significant and nonsignificant improvements were observed in another 2 (muscle strength and independence in day-to-day activities), depending on the measurement tools or methods used.Trial RegistrationPROSPERO CRD42021256826; https://tinyurl.com/2uarftbh

Genetic Factors, Brain Atrophy, and Response to Rehabilitation Therapy After Stroke

Objective Patients show substantial differences in response to rehabilitation therapy after stroke. We hypothesized that specific genetic profiles might explain some of this variance and, secondarily, that genetic factors are related to cerebral atrophy post-stroke. Methods The phase 3 ICARE study examined response to motor rehabilitation therapies. In 216 ICARE enrollees, DNA was analyzed for presence of the BDNF val66met and the ApoE ε4 polymorphism. The relationship of polymorphism status to 12-month change in motor status (Wolf Motor Function Test, WMFT) was examined. Neuroimaging data were also evaluated (n=127). Results Subjects were 61±13 years old (mean±SD) and enrolled 43±22 days post-stroke; 19.7% were BDNF val66met carriers and 29.8% ApoE ε4 carriers. Carrier status for each polymorphism was not associated with WMFT, either at baseline or over 12 months of follow-up. Neuroimaging, acquired 5±11 days post-stroke, showed that BDNF val66met polymorphism carriers had a 1.34-greater degree of cerebral atrophy compared to non-carriers (P=.01). Post hoc analysis found that age of stroke onset was 4.6 years younger in subjects with the ApoE ε4 polymorphism (P=.02). Conclusion Neither the val66met BDNF nor ApoE ε4 polymorphism explained inter-subject differences in response to rehabilitation therapy. The BDNF val66met polymorphism was associated with cerebral atrophy at baseline, echoing findings in healthy subjects, and suggesting an endophenotype. The ApoE ε4 polymorphism was associated with younger age at stroke onset, echoing findings in Alzheimer’s disease and suggesting a common biology. Genetic associations provide insights useful to understanding the biology of outcomes after stroke.

Finger Exoskeleton in Simple Motor Rehabilitation Therapy on Arm and Hand Muscle Ability of Post-Stroke Sufferers

Post-stroke sufferers will generally experience weakness on one side of the body, balance, vision, sensory, motor, and cognitive. In West Kalimantan, the estimated stroke sufferer in 2013 was 25,195 people. Based on data from the Public Hospital of Dr. Soedarso Pontianak shows a significant increase from January 2018 to December 2018 totaling 722 people. The research objective was to assess the effectiveness of the finger exoskeleton tool in simple motor therapy on the ability of the client's arm and hand muscles after a stroke. This study used a quantitative approach with a quasi-experimental design. Pre-test and Post-test Nonequivalent Control Group with two groups, which were the control group of 12 people and the intervention group of 12 people with finger exoskeleton tools. The statistical test used was the independent t test and paired t test. Measurement of muscle ability with the Action Research Arm Test. Analysis of the difference in total scores between before and after treatment in the intervention group using Paired T-Test obtained a p-value of 0.000 (p value &lt;0.05) and in the control group using the Wilcoxon test a p-value of 0.016 (p value &lt;0.05). It shows that there is a significant difference in the total score between before and after finger exoskeleton therapy and range of motion. Intervention of finger exoskeleton assistive devices in simple motor rehabilitation therapy is effective in increasing the ability of the client's arm and hand muscles after stroke. It is recommended to make another finger rehabilitation tool with a more optimal design according to the parameters, which are the severity of the client after stroke, subject kinematics, control of movement torque and adaptation between the subject and the robotic device used.

Post-stroke cognitive impairments and responsiveness to motor rehabilitation: A review.

a)This review discusses the prevalence of cognitive deficits following stroke and their impact on responsiveness to therapeutic intervention within a motor learning context. b)Clinical and experimental studies have established that post-stroke cognitive and motor deficits may impede ambulation, augment fall risk, and influence the efficacy of interventions. Recent research suggests the presence of cognitive deficits may play a larger role in motor recovery than previously understood. c)Considering that cognitive impairments affect motor relearning, post-stroke motor rehabilitation therapies may benefit from formal neuropsychological testing. For example, early work suggests that in neurotypical adults, cognitive function may be predictive of responsiveness to motor rehabilitation and cognitive training may improve mobility. This sets the stage for investigations probing these topics in people post-stroke. Moreover, the neural basis for and extent to which these cognitive impairments influence functional outcome remains largely unexplored and require additional investigation.

Unobtrusive Inference of Affective States in Virtual Rehabilitation from Upper Limb Motions: A Feasibility Study

Virtual rehabilitation environments may afford greater patient personalization if they could harness the patient's affective state. Four states: anxiety, pain, engagement and tiredness (either physical or psychological), were hypothesized to be inferable from observable metrics of hand location and gripping strength-relevant for rehabilitation. Contributions are; (a) multiresolution classifier built from Semi-Naïve Bayesian classifiers, and (b) establishing predictive relations for the considered states from the motor proxies capitalizing on the proposed classifier with recognition levels sufficient for exploitation. 3D hand locations and gripping strength streams were recorded from 5 post-stroke patients whilst undergoing motor rehabilitation therapy administered through virtual rehabilitation along 10 sessions over 4 weeks. Features from the streams characterized the motor dynamics, while spontaneous manifestations of the states were labelled from concomitant videos by experts for supervised classification. The new classifier was compared against baseline support vector machine (SVM) and random forest (RF) with all three exhibiting comparable performances. Inference of the aforementioned states departing from chosen motor surrogates appears feasible, expediting increased personalization of virtual motor neurorehabilitation therapies.

Enhanced Descending Corticomuscular Coupling During Hand Grip With Static Force Compared With Enhancing Force.

The interaction between cortex and muscles under hand motor with different force states has not been quantitatively investigated yet, which to some extent places the optimized movement tasks design for brain-computer interface (BCI) applications in hand motor rehabilitation under uncertainty. Converging evidence has suggested that both the descending corticospinal pathway and ascending sensory feedback pathway are involved in the generation of corticomuscular coupling. The present study aimed to explore the corticomuscular coupling during hand motor task with enhancing force and steady-state force. Twenty healthy subjects performed precision grip with enhancing and static force using the right hand with visual feedback of exerted force. Mutual information and Granger causal connectivity were assessed between electroencephalography (EEG) over primary motor cortex and electromyography (EMG) recordings, and statistically analyzed. The results showed that the mutual information value was significantly larger for static force in the beta and alpha frequency band than enhancing force state. Furthermore, compared with enhancing force, the Granger causal connectivity of descending pathways from cortex to muscle was significantly larger for static force in the beta and high alpha frequency band (10-20 Hz), indicating the connection between the primary motor cortex and muscle was strengthened for static force. In summary, the hand grip with static force resulted in an increasing corticomuscular coupling from EEG over the primary motor cortex to EMG compared with enhancing force, implying more attention was required in the static force state. These results have important implications toward motor rehabilitation therapy design for the recovery of impaired hand motor functions.

An Adaptive Virtual Reality-Based Serious Game for Therapeutic Rehabilitation

&lt;span lang="EN-US"&gt;Conventional motor rehabilitation therapies followed by stroke survivors during their recovery process, are typically intense and involve numerous repetitions of task-specific recommended exercises. However, due to the lack of short-term or immediate results, patients tend to lose motivation on the rehabilitation process, and on performing the therapist recommended exercises at home between sessions. The work described in this article proposes to engage the patients with the therapeutic exercises by transforming the latter into specially designed serious games. After an initial evaluation by therapists, a pilot study was conducted on a rehabilitation clinic that showed that this system is adequate for about 75% of the clinical cases treated. The proposed game was globally well-accepted by patients, showing to be motivational and engaging. These promising results lead us to believe that immersive-based games can indeed be a valuable aid for motor rehabilitation therapies.&lt;/span&gt;

Gamifying Motor Rehabilitation Therapies: Challenges and Opportunities of Immersive Technologies

Recovering from a traumatic incident (e.g, a stroke) implies rigorous and demanding therapies to ensure recovery of the lost capabilities. Due to the lack of short-term visible results, stroke patients tend to lose interest in their recovery process and frequently do not follow their therapists’ suggestions to continue performing their training at home, between physiotherapy sessions. This article explores the extent to which common computer games or specifically crafted games can serve as a rehabilitation practice, but also how conventional therapeutic devices might be transformed to be incorporated into games. Furthermore, we propose a platform that follows the opportunity of creating serious games that are designed for stroke patients with reduced upper limb mobility while following the same principles of common therapeutic procedures. This platform was carefully built with the purpose of allowing patients to comply tele-rehabilitation and promoting the execution of the recommended training at home. Following these ideas, we integrated two carefully designed games that have been tested and validated in our previous works, and we added a top-layer characterized by an online back-end application for therapists that allows them to observe their patients’ progress over time and draw different conclusions.

A Socially Assistive Robotic Platform for Upper-Limb Rehabilitation: A Longitudinal Study With Pediatric Patients

In motor rehabilitation therapies, especially with pediatric patients, there is often a loss of interest and motivation due to the lack of variety in exercises and therapeutic activities. NAOTherapist (NT) is a socially assistive robotics (SAR) platform designed to support hands-off rehabilitation sessions through two interactive games: mirror and Simon. It integrates a cognitive architecture with an NAO humanoid robot that acts as a coach, as well as a red-green-blue-depth (RGB-D) sensor that eases body capture. This work aims to deploy and evaluate the developed technology for a long-term experience.

Feasibility of a randomised controlled trial to evaluate home-based virtual reality therapy in children with cerebral palsy

Purpose Evidence is increasing for effective virtual reality therapy for motor rehabilitation for children with Cerebral Palsy. We assessed the feasibility of a virtual reality therapy mode of intervention, appropriateness of measures, and potential cost-effectiveness. Methods A 12-week, 2-group, parallel-feasibility trial (ISRCT 17624388) using Nintendo Wii FitTM at home. Children aged 5–16, with ambulatory Cerebral Palsy, who were able to follow simple instructions were randomised to two groups; one supported by physiotherapists (individualised activity programme), the other unsupported with children having free choice (control). Children were assessed in clinic at baseline, week 6, and week 12 by blinded assessors. Feasibility of the intervention was assessed via recruitment, adherence, and usefulness of measurement tools. Results Forty-four children were eligible (out of 48 approached): 31 consented, 30 were randomised, 21 completed the study; 10 in the supported group and 11 in the unsupported group. Nine children discontinued from tiredness, after-school activities, homework, surgery, technical difficulties or negative system feedback. The supported group completed 19 of 36 (IQR 5-35) possible sessions; the unsupported group 24 of 36 sessions (IQR 8-36). Gross Motor Function Measure scores varied by Cerebral Palsy severity after the intervention. There were no adverse events. Conclusion Virtual reality therapy offers potential as a therapeutic adjunct for children with Cerebral Palsy, warranting substantive confirmatory study. Gross Motor Function Measure, with modifications to improve sensitivity, appeared appropriate as a primary measure, with Timed up and Go test secondary. The intervention was inexpensive costing £20 per child. An explanatory trial to evaluate the clinical/cost-effectiveness of commercial system virtual reality therapy is feasible with minor methodological adaptation. Implications for rehabilitation Home-based interactive computer gaming was feasible, safe and cost effective as a therapy adjunct. Discontinue if additional pressures are present: imminent surgery, family resilience to technical difficulties, negative system feedback, after-school activities. Change in Gross Motor Function Measurement scores varied by severity of Cerebral Palsy.

An EEG/EMG/EOG-Based Multimodal Human-Machine Interface to Real-Time Control of a Soft Robot Hand.

Brain-computer interface (BCI) technology shows potential for application to motor rehabilitation therapies that use neural plasticity to restore motor function and improve quality of life of stroke survivors. However, it is often difficult for BCI systems to provide the variety of control commands necessary for multi-task real-time control of soft robot naturally. In this study, a novel multimodal human-machine interface system (mHMI) is developed using combinations of electrooculography (EOG), electroencephalography (EEG), and electromyogram (EMG) to generate numerous control instructions. Moreover, we also explore subject acceptance of an affordable wearable soft robot to move basic hand actions during robot-assisted movement. Six healthy subjects separately perform left and right hand motor imagery, looking-left and looking-right eye movements, and different hand gestures in different modes to control a soft robot in a variety of actions. The results indicate that the number of mHMI control instructions is significantly greater than achievable with any individual mode. Furthermore, the mHMI can achieve an average classification accuracy of 93.83% with the average information transfer rate of 47.41 bits/min, which is entirely equivalent to a control speed of 17 actions per minute. The study is expected to construct a more user-friendly mHMI for real-time control of soft robot to help healthy or disabled persons perform basic hand movements in friendly and convenient way.

PROGame: A process framework for serious game development for motor rehabilitation therapy.

Serious game development for rehabilitation therapy is becoming increasingly popular because of the motivational advantages that these types of applications provide. Consequently, the need for a common process framework for this category of software development has become increasingly evident. The goal is to guarantee that products are developed and validated by following a coherent and systematic method that leads to high-quality serious games. This paper introduces a new process framework for the development of serious games for motor rehabilitation therapy. We introduce the new model and demonstrate its application for the development of a serious game for the improvement of the balance and postural control of adults with cerebral palsy. The development of this application has been facilitated by two technological transfer contracts and is being exploited by two different organizations. According to clinical measurements, patients using the application improved from high fall risk to moderate fall risk. We believe that our development strategy can be useful not only for motor rehabilitation therapy, but also for the development of serious games in many other rehabilitation areas.

Sensory–motor rehabilitation therapy for task-specific focal hand dystonia: A feasibility study

IntroductionMedical treatments have limited long-term effect in task-specific dystonia. Whilst evidence supports the use of rehabilitation, no randomised controlled trials have been undertaken. This small-scale study determined the feasibility of implementing and evaluating a mixed sensory–motor task-specific dystonia rehabilitative programme.MethodsParticipants with writer’s or musician’s dystonia were recruited from a movement disorder and hand therapy clinic. Feasibility measures were recruitment rate, retention, session attendance, adherence to exercises. Self-report measures at 0, 3 and 6 months included: Arm Dystonia Disability Scale (ADDS), Tubiana and Chamagne Scale (TCS), Brief Illness Perception Questionnaire (BIPQ), Health Status (EQ-5D 5L), Clinical Global Impression Scale (CGI). Task performance was video-recorded at baseline and 6 months. At 6 months, interviews explored participant experiences of the intervention.ResultsFifteen patients were recruited over 6 months (rate 2.5/month, musician’s dystonia = 8, writer’s dystonia = 7). Complete data sets were collected for twelve people(80%). The programme comprised a maximum six sessions plus daily home exercises. Nine completed the home programme at ≥75%. No adverse events were reported. Effect sizes at 3 and 6 months, respectively, were ADDS 3-month = 0.28, 6-month = 0.23; TCS 3-month = 0.13, 6-month = 0.53; BIPQ 3-month = 0.38, 6-month = 0.71; EQ-5D-5L 3-month = 0.34, 6-month = 0.59; video analysis at 6 months = 0.78. Eleven (92%) improved on the CGI. Interviews supported acceptability of the intervention.ConclusionsThis intervention was feasible to deliver with high retention, adherence and acceptability. Improvements occurred across measures. This informs the development of future randomised controlled trials.

Decoding Upper Limb Movement Attempt From EEG Measurements of the Contralesional Motor Cortex in Chronic Stroke Patients.

Stroke survivors usually require motor rehabilitation therapy as, due to the lesion, they completely or partially loss mobility in the limbs. Brain-computer interface technology offers the possibility of decoding the attempt to move paretic limbs in real time to improve existing motor rehabilitation. However, a major difficulty for the practical application of the BCI to stroke survivors is that the brain rhythms that encode the motor states might be diminished due to the lesion. This study investigates the continuous decoding of natural attempt to move the paralyzed upper limb in stroke survivors from electroencephalographic signals of the unaffected contralesional motor cortex. Experiments were carried out with the aid of six severely affected chronic stroke patients performing/attempting self-selected reaching movements of the unaffected/affected upper limb. The electroencephalographic (EEG) analysis showed significant cortical activation on the uninjured motor cortex when moving the contralateral unaffected arm and in the attempt to move the ipsilateral affected arm. Using this activity, significant continuous decoding of movement was obtained in six out of six participants in movements of the unaffected limb, and in four out of six participants in the attempt to move the affected limb. This study showed that it is possible to construct a decoder of the attempt to move the paretic arm for chronic stroke patients using the EEG activity of the healthy contralesional motor cortex. This decoding model could provide to stroke survivors with a natural, easy, and intuitive way to achieve control of BCIs or robot-assisted rehabilitation devices.